The pharmacology and toxicology of the stimulant khat
Saudi Journal for Health Sciences May 20, 2026 Hadeel A. Alsufyani
Khat chewing, a traditional practice in the Horn of Africa and Yemen, delivers stimulant effects through its active compounds. Fresh khat is rich in cathinone, a potent central nervous system stimulant that acts on dopamine and norepinephrine transporters similarly to amphetamine. Dried khat has reduced cathinone but higher levels of cathine and norephedrine, which act more peripherally. Cathine can match cathinone's cardiovascular toxicity but not its central psychostimulant effects. Switching from fresh to dried khat increases cardiovascular risks relative to central stimulation, while the reverse may cause excessive central stimulation. Awareness of khat's health consequences should be increased.